Woman ruled man is woman

A Dutch athlete suspended in 1950 by the Dutch Athletics Union on the grounds that she was actually a man, has finally been vindicated thanks to DNA technology.

The story of the downfall of Foekje Dillema – a Frisian athlete at one time slated to become an Olympic champion – reads like a thriller but elicits mainly our deep-felt sympathy. Clinical geneticist Dr Kamlesh Madan of Leiden University says that, despite having some male physical features, Dillema was undoubtedly a woman.

“She was definitely a woman and she should never have been expelled by the Athletics Union. No way.”

Genetic mosaic

With hindsight it’s not really so strange there should have been doubts about Dillema’s gender. She was unusually large and heavily-muscled, in the words of a sports reporter of the time she had “a man’s legs” and her face was distinctly masculine-looking. Even so, to this day former athletes who ran with her have no doubts she was a woman.

And now DNA testing has provided the proof. She was indeed a woman, although researchers at the Erasmus Medical Centre in Rotterdam prefer to say she was “on balance” a woman. She was a woman with a certain percentage of male cells. She was a genetic variant popularly known as a “mosaic”: a person with both XX (female) and XY (male) chromosomes.

Gender issue

For decades the real gender of female athletes has been a source of controversy. East Germany’s Olympic shot-putters came under particular suspicion. Extreme doping with the male hormone testosterone may have made them almost indistinguishable from men, but they were still women.

It was common practice for all female athletes at the Olympics to undergo gender testing until, after years of protest, it was finally stopped in the 1990s. Dr Madan explains:

“In 1996 sports executives came to the conclusion that gender testing was inappropriate. The early tests were extremely unreliable and the later ones only slightly better. However, the point is the medical principle. There are many reasons a woman might have a small number of XY chromosomes.”

Urban myth

Once the rumour mill has started casting doubt on the gender of a sportsperson there is usually nothing sensible to be said. Even Amélie Mauresmo, the French tennis star who became the world number one in 2004, has heard whispers that she is actually a man. Why? Because she is openly lesbian and has quite a strong jawline.

Stories about top male athletes undergoing sex change operations and then winning in women’s competitions fall into the category of “urban myth”. A sex change “takes years“, points out cosmetic surgeon Jan Hage of the Free University of Amsterdam, who has carried out many of these operations,

“It is exhausting and inevitably results in “female” levels of muscle power, stamina and fat percentage. In sporting terms, you’re just going backwards!”

Back to Foekje

Foekje Dillema was something different, a unique medical mix of circumstances which is extremely uncommon but completely natural. Dr Madan says that

“there are only a couple of hundred known cases in the world, and in most of those cases almost nothing can be seen. These women are simply one hundred percent women. But when there are too many XY chromosomes and they are located in the vicinity of the sex organs, testicular cells can be create which are capable of producing the male hormone testosterone.”

A genetic mosaic like Foekje Dillema can be created when two embryos, one male and one female, merge in the womb a few days after conception. Normally this would result in a miscarriage, but in exceptional circumstances a child can be born which has some chromosomes of the other gender.

In Foekje’s case, the researchers in Rotterdam discovered that one-third of her chromosomes were male. That is a very large percentage and it’s not surprising it helped her athletic performances.

Rest in peace

Dillema’s gender has now finally been decided. It is interesting in scientific terms and a fine scoop for journalists, but it is not a happy ending. From her suspension in 1950 onwards, Foekje Dillema led a secluded life and wanted only thing: to be left in peace. She died last year in an old people’s home in Kollum, in her native Frisia, believing she had taken her secret with her to her grave.